Objectives Intentional injury, including interpersonal violence and self-harm, is one of the world’s leading causes of preventable injury. In Europe alone, nearly 1.5 million individuals receive medical treatment each year for a violence-related injury. We examined violent injuries treated in the largest Emergency Department (ED) in Tîrgu Mures County, Romania, with a catchment area of approximately 580 000 residents to describe the epidemiology of assault and self-harm injuries. Methods Data were collected as part of the European Injury Database project, from a sample of patients who presented with a violence-related injury and received care from the ED of the Mures County Emergency Hospital, Romania. The data were collected for 9 months by two trained emergency physicians. Information about individual demographics; mechanism, nature, place, and activity of injury; injury types, and body regions affected; and discharge state were compared for assault and self-harm injuries. Results Of the 380 patients treated for violence-related injuries, 88.7% were for assault and 11.3% were for self-harm. For both types of injuries, the majority of patients were between the ages of 15 and 44. Assaults frequently occurred in the home, on streets and highways, or in public places; and men (80.4%) were far more likely than women (19.6%) to be treated for this type of injury; a slightly higher proportion of men (55.8%) than women (44.2%) were treated for self-harm, most of which occurred in homes. Discussion Of all injuries treated in the Tîrgu Mures ED, one out of five was violence related. One out of 10 patients that suffered an injury as a consequence of a violent event and treated in the ED required admission to a hospital for further medical care, leading to a significant health care burden. These data suggest that prevention strategies should focus on young adults, and particularly men. Interventions that focus on detection and treatment of psychological illness, reduction of alcohol use and associated aggression, and family and intimate partner violence are suggested as priorities.

Health literacy improves knowledge and builds skills to help individuals make appropriate decisions regarding their health. Over the past 20 years, several studies have described associations between health literacy and health outcomes. With respect to Romania, evidence is scarce on the level of health literacy, as well as on its determinants. Thus, the objectives of this study were to briefly screen functional health literacy levels in a sample of rural inhabitants, to assess the relationship between health literacy and reported health status, as well as to explore health literacy determinants within this population. Data were collected between September-November 2010, in four villages in Cluj County, Romania, using a cross-sectional survey. The mean age of respondents in the sample was 56 years, with roughly half of respondents being retired. The brief screening of health literacy suggested inadequate to marginal levels within the sample. Significant associations were observed between health literacy score and education, and self-perceived health status, whereas the relationship between health literacy and gender, and the presence of a chronic disease was not statistically significant. Limited health literacy has been shown to be common in people who rated their health as poor, those who attended only middle school, and individuals lacking basic information about their body. In order to minimize the adverse effects of low health literacy on health and health outcomes, efforts should be invested in identifying and addressing the health needs of adults with low and marginal health literacy, especially in underserved areas such as rural and remote settings, where access to health-related information is limited.

Our results show an urgent need to address EDs prevention in adolescent girls and boys from the community.

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